Modified Dental Anxiety Scale Research Articles

Impact of non-surgical periodontal treatment on dental anxiety: A comparative study on patients with periodontitis

Background/purposeDental anxiety is prevalent and may result in the avoidance of periodontal therapy and maintenance. This study aimed to explore the impact of non-surgical periodontal treatment (NSPT) on dental anxiety among patients with periodontitis. Materials and methodsIn this study, 122 patients with periodontitis participated. The Chinese version of the Modified Dental Anxiety Scale (MDAS) gauged baseline dental anxiety during the initial appointment. Patients receiving non-surgical periodontal treatment (NSPT) in subsequent appointments formed the NSPT group, while those with a delayed NSPT of at least two months constituted the delayed group. In the NSPT group, the second termination questionnaire was administered one month post the last NSPT visit, just before the periodontal re-evaluation. In the delayed group, the second questionnaire was completed before the delayed NSPT initiation. ResultsBaseline MDAS scores were comparable between the delay and NSPT groups. However, the NSPT group exhibited lower total scores and scores for each of the five MDAS items at termination compared with the delay group. At baseline, MDAS total scores were inversely associated with age and were lower in males. A reduction in MDAS total scores between observation points was correlated with NSPT, sex, and age after adjustment. Regarding MDAS item 4 (teeth scaled/polished), score reduction consistently correlated with NSPT and age. ConclusionParticipation in NSPT may alleviate dental anxiety, and consequently enhance the patients' conceptiveness to undergo periodontal maintenance or surgery.

Do Parents Dental Neglect and Anxiety Affect Their Children s Dental Neglect and Anxiety

Aim: Dental neglect is an obstacle to obtaining the necessary dental care in protecting and maintaining basic oral health. Dental anxiety can cause difficulties in behavior management, maintenance of dental treatments, and poor oral hygiene. In this study, it was aimed to examine the relationship between dental neglect and anxiety levels of both parents and their children. Material and Methods: 220 people including 110 parents and 110 children were included in the study. The Dental Neglect Scale (DNS), Modified Dental Anxiety Scale (MDAS), and Visual Analogue Scale (VAS) were used for parents. In addition, the Dental Neglect Scale (DNS), the Faces version of the Modified Child Dental Anxiety Scale (MCDASf), and the Wong Baker Faces Pain Rating Scale (WBFS) were applied to children. The statistical analysis was performed using Spearman Correlation test and Mann Whitney-U test. Results: In the study, a positive correlation was found between parent’s and children's neglect scores (r=0.261; p=0.006). Likewise, a positive correlation was observed between the DMFT and anxiety scores of the children (r=0.237; p= 0.013). In addition, it was observed that there was a statistical correlation between the level of pain felt at the last dental treatment and anxiety in children (r=0.316; p=0.001). Conclusion: It was observed that the dental neglect of the children of parents who neglected their own oral health increased. It is thought that informing parents about the importance of oral health and the consequences of dental neglect will have positive effects on their children's oral health.

Analysis of acupoint massage combined with touch on relieving anxiety and pain in patients with oral implant surgery.

Oral implant surgery is an effective procedure for artificial implants in missing tooth areas under local anesthesia. Because patients under local anesthesia are conscious during this procedure, compared with general anesthesia-related operations, they are more likely to experience negative emotions, such as anxiety and tension. These emotional reactions result in shivering and chills in the limbs, leading to poor doctor-patient cooperation and even avoidance of treatment. In traditional Chinese medicine, it is believed that acupoint massage regulates blood and Qi, dredge menstruation, and relieve pain, which is beneficial for patients' emotional adjustment; however, there are few related clinical studies. To observe the changes in anxiety and pain in patients with oral implant after acupoint massage combined with touch therapy. One hundred patients undergoing oral implantation in our hospital between May 2020 and May 2023 were randomly divided into control and study groups, according to a random number table, with 50 patients in each group. The control group received routine intervention, and the study group received acupoint massage combined with touch on the basis of the control group. Anxiety [assessed using the Modified Dental Anxiety Scale (MDAS)], pain severity, blood pressure, heart rate, and satisfaction were compared between the two groups. Before intervention, the difference in MDAS score between the two groups was not significant (P > 0.05), while after the intervention, the MDAS scores decreased in both groups compared with those before the intervention (P < 0.05); the MDAS score of the study group was lower than that of the control group, with a statistically significant difference (P < 0.05). The degree of pain in the intervention group was significantly lower than that in the control group (P < 0.05). Before the intervention, there were no significant differences in systolic and diastolic blood pressures or heart rate between the two groups (P > 0.05). The systolic and diastolic blood pressures and heart rate in the intervention group, during and after the intervention, were significantly lower than those in the control group (P < 0.05). The total degree of satisfaction in the study group was significantly higher than that in the control group (P < 0.05). Acupoint massage combined with touch better relieves anxiety and pain in patients undergoing dental implant surgery, improving the perioperative comfort of these patients and ensuring safety and a smooth operation.

Autonomic Nervous System Activity and Dental Anxiety in the Northern Finland Birth Cohort (NFBC1966) Population.

Autonomic nervous system (ANS) activity may be associated with dental anxiety; however, no studies exist on the topic. The aim of this study was to assess if ANS activity and dental anxiety are associated. Data were collected as part of a Northern Finland Birth Cohort Study, NFBC1966, at the age of 46 years with eligible data on 1905 participants. Dental anxiety was measured using the Modified Dental Anxiety Scale (MDAS) categorized as follows: 19-25 = high, 10-18 = moderate, 5-9 = no to low dental anxiety. Heart rate variability (HRV) data were collected using an HR monitor and a standard lead-II electrocardiogram (ECG). Baroreflex sensitivity (BRS) was calculated from continuous ECG and blood pressure signals. Participants were categorized into three groups as follows: Low = the lowest 20th percentile, Mid = medium 21-79th percentile, and High = the highest 20th percentile according to their ANS variables. The associations between the MDAS and ANS activity parameters were evaluated using unordered multinomial logit models adjusted for comorbidities, β-blockers, BMI, smoking, and education. High heart rate, reduced HRV, low cardiac vagal modulation, and poor BRS were associated with moderate dental anxiety, and high cardiac vagal modulation and good BRS were associated with no to low dental anxiety. Poorer ANS activity might predispose some to dental anxiety, and better ANS activity might protect from dental anxiety.

Influence of experiencing SARS-CoV-2 infection on anxiety levels in Chinese patients undergoing third molar surgery.

In China, most of the citizens experienced SARS-CoV-2 infection since the end of 2022. The Coronavirus disease 2019 (COVID-19) pandemic affected people's physical health and also had a significant impact on mental well-being. The present study aims to discover if the experience of SARS-CoV-2 infection influences patients' anxiety toward third molar surgery in the Chinese population. The present study took the form of a questionnaire survey. From January 1, 2023, to June 30, 2023, patients who went to the Stomatology Center of China-Japan Friendship Hospital (Beijing, China) for the third molar extraction were included according to the inclusion criteria. The information on COVID-19 infection and the Modified Dental Anxiety Scale (MDAS) was collected. The software SPSS 22.0 was used for the statistical analyses. A total of 574 survey results were harvested in the present study. The infection rate of COVID-19 was 86.6% (p > 0.05). The Average MDAS scores between patients who had been infected with COVID-19 and patients who were never infected were not significantly different (11.65 ± 4.41 vs. 11.42 ± 4.41, p > 0.05). The subgroup analysis was conducted according to the length of time after the recovery of COVID-19 (Model 1), and the highest temperature during the infection (Model 2). In Model 1 and Model 2, the one-way ANOVA test did not find statistical significance between the groups (Model 1 p = 0.114; Model 2 p = 0.481). The MDAS scores in female patients were significantly higher than in male patients (12.29 ± 4.53 vs. 9.91 ± 3.80, p < 0.001). Patients who extracted double teeth got significantly higher MDAS scores than those who extracted single teeth before the surgery (12.03 ± 4.74 vs. 11.24 ± 4.18, p = 0.037). The present study did not establish a significant impact of SARS-CoV-2 infection on the anxiety levels associated with third molar surgery among Chinese patients. The potential long-term biopsychological effects of the virus warrant further investigation.

EFFECT OF DENTAL ANXIETY ON ORAL HEALTH VALUE AMONG PROFESSIONAL ADULTS - A CORRELATIONAL STUDY

Background: An individual’s level of education has great influence on oral health. The oral health value scale (OHVS) is a newly developed scale which is comprised of four subscales which forms a prime behavior in preventing poor oral health. Modified Dental anxiety scale (MDAS) is a widely used scale for assessing dental anxiety. Objective: The study was conducted to correlate dental anxiety on oral health value of a professional adult and its effect on age. Methods and Materials: Cross-sectional study was conducted among (n=116) professional adults. Voluntary sampling technique was considered to recruit the participants. Demographic data, two pre-validated tools i.e., the MDAS and OHVS were used to obtain the data. Results: Out of 116 participants 64% were males and 36% were females. Females had significantly high level of anxiety compared to males (p=0.001). There was significant association of MDAS and OHVs with age (p≤0.005). Pearson correlation between MDAS and OHVS showed a positive association with the flossing subscale and a negative association with professional dental care, retaining natural teeth and appearance subscale of OHVS. Conclusion: An individual’s score of OHVS is found to be influenced by dental anxiety. Factors like professional dental care has been reported to be inversely associated with dental anxiety. Individuals with high anxiety need to be counselled for building a positive attitude towards oral hygiene which will give high values to oral health.

Predicting dental anxiety in young adults: classical statistical modelling approach versus machine learning approach

ObjectivesTo predict and identify the key demographic and clinical exposure factors associated with dental anxiety among young adults, and to compare if the traditional statistical modelling approach provides similar results to the machine learning (ML) approach in predicting factors for dental anxiety.MethodsA cross-sectional study of Western Illinois University students. Three survey instruments (sociodemographic questionnaire, modified dental anxiety scale (MDAS), and dental concerns assessment tool (DCA)) were distributed via email to the students using survey monkey. The dependent variable was the mean MDAS scores, while the independent variables were the sociodemographic and dental concern assessment variables. Multivariable analysis was done by comparing the classical statistical model and the machine learning model. The classical statistical modelling technique was conducted using the multiple linear regression analysis and the final model was selected based on Akaike information Criteria (AIC) using the backward stepwise technique while the machine learining modelling was performed by comparing two ML models: LASSO regression and extreme gradient boosting machine (XGBOOST) under 5-fold cross-validation using the resampling technique. All statistical analyses were performed using R version 4.1.3.ResultsThe mean MDAS was 13.73 ± 5.51. After careful consideration of all possible fitted models and their interaction terms the classical statistical approach yielded a parsimonious model with 13 predictor variables with Akaike Information Criteria (AIC) of 2376.4. For the ML approach, the Lasso regression model was the best-performing model with a mean RMSE of 0.617, R2 of 0.615, and MAE of 0.483. Comparing the variable selection of ML versus the classical statistical model, both model types identified 12 similar variables (out of 13) as the most important predictors of dental anxiety in this study population.ConclusionThere is a high burden of dental anxiety within this study population. This study contributes to reducing the knowledge gap about the impact of clinical exposure variables on dental anxiety and the role of machine learningin the prediction of dental anxiety. The predictor variables identified can be used to inform public health interventions that are geared towards eliminating the individual clinical exposure triggers of dental anxiety are recommended.

Two-Year Trajectories of Dental Anxiety in Parents and Their Association with Parents' and Children's Oral Healthcare Procedures in FinnBrain Birth Cohort Study.

We aimed to identify parents' dental anxiety trajectories and the association of the trajectories with the number of parents' and their children's oral healthcare procedures in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale at gestational weeks (gw) 14 and 34, as well as 3 and 24 months (mo) after childbirth. Oral healthcare procedures from gw14 to 24 mo were obtained from the national patient data register and categorized as preventive and treatment. Trajectories were identified with latent growth mixture modelling for 2068 fathers and 3201 mothers. Associations between trajectories and procedures adjusted for education were analyzed using unordered multinomial logit models. Fathers' trajectories were stable low (80.1%), stable high (3.4%), stable moderate (11.0%), moderate increasing (3.9%) and high decreasing (1.6%). Mothers' trajectories were stable low (80.7%), stable high (11.2%), moderate increasing (5.3%) and high decreasing (2.8%). Mothers with decreasing dental anxiety had a higher number of preventive and treatment procedures. Fathers with decreasing dental anxiety had a higher number of preventive and treatment procedures, while fathers with increasing dental anxiety had fewer procedures. Children of mothers with stable low dental anxiety had higher number of preventive procedures. There seems to be a two-way association between dental anxiety trajectories and oral healthcare procedures.

Associations of sensory sensitivity, pain catastrophizing, and alexithymia with dental anxiety.

We aimed to reveal interrelationships between alexithymia, catastrophic thinking, sensory processing patterns, and dental anxiety among 460 participants who were registrants of a Japanese research company. Measures used were the Modified Dental Anxiety Scale, the Adult Sensory Profile, the Pain Catastrophizing Scale, and the 20-item Toronto Alexithymia Scale. The interrelationships among the constructs were analyzed using structural equation modeling, adjusting for age, gender, and negative dental treatment experience. Data from 428 participants were used in the analyses. Sensory sensitivity and pain catastrophizing were independently associated with anticipatory and treatment-related dental anxiety, while difficulty identifying feelings was not. In the mediation model, sensory sensitivity and pain catastrophizing served as full mediators between difficulty identifying feelings and the dimensions of dental anxiety (indirect effects were between 0.13 and 0.15). The strength of the associations was 0.55 from difficulty identifying feelings to both pain catastrophizing and sensory sensitivity, and between 0.24 and 0.26 to anticipatory and treatment-related dental anxiety. The association between trait-like phenomena, such as alexithymia, and dental anxiety may be mediated by neurophysiological and cognitive factors such as sensory sensitivity and pain catastrophizing. These findings could be crucial for new and innovative interventions for managing dental anxiety.

COMPARISON OF DENTAL EXTRACTION ANXIETY AND DEPRESSION BETWEEN YOUNG AND OLDER ADULTS

Dental anxiety and depression represent significant psychological factors that can influence an individual's willingness to seek and undergo dental treatments, including routine procedures such as dental extractions. The main objective of the study is to find the comparison of dental extraction anxiety and depression in young adults as compared to older adults. This cross-sectional study was conducted in Karachi from January 2023 to November 2023.  Data was collected from 320 participants in two age groups: young and older adults. Young adults age 8-35 years and older adults 60 years and above. Demographic information, including age, gender, education level, and dental history, was gathered alongside clinical details such as the type and complexity of dental extractions. Validated scales, notably the Modified Dental Anxiety Scale (MDAS) for dental anxiety and the Patient Health Questionnaire-9 (PHQ-9) for depression were employed for assessment. Data were collected from 320 participants. Approximately 36% of the population is estimated to be affected by dental anxiety, with 10 to 20% experiencing extreme levels. The mean Modified Dental Anxiety Scale (MDAS) scores differed significantly between age groups, with young adults having a mean score of 16.2 (SD=4.5) compared to older adults with a mean score of 14.5 (SD=3.8) (p&lt;0.05). Similarly, the mean Patient Health Questionnaire-9 (PHQ-9) scores varied significantly between age groups, showing that young adults had a higher mean score of 8.3 (SD=3.2) compared to older adults with a mean score of 6.7 (SD=2.8) (p&lt;0.01). It is concluded that gender and educational influences further emphasize the need for personalized approaches in dental care. Tooth extraction anxiety and depression are common in older adults. These insights highlight the potential for integrating mental health considerations into routine dental practices, fostering more patient-centered and age-specific interventions to enhance oral health and well-being.

Assessment of patients’ dental anxiety levels in the context of infectious diseases: development and validation of Musa Kazim’s Dental Anxiety Scale (MK-DAS)

ObjectivesThe study aimed to develop and validate a new scale called Musa Kazim’s Dental Anxiety Scale (MK-DAS) to measure dental anxiety in relation to infectious diseases.MethodsThe study utilized a cross-sectional design and recruited participants from Faculty of Dentistry, Altinbas University. The sample included 289 participants who were seeking dental treatment. The Modified Dental Anxiety Scale (MDAS) was employed for the purpose of assessing levels of dental anxiety. In contrast, the MK-DAS, comprised a series of seven inquiries specifically targeting concerns regarding the treatment procedure and the fear of contagion. The data was analyzed using various statistical methods, including descriptive statistics, exploratory factor analysis, criterion validity, cluster analysis for cut-off points, and test-retest reliability.ResultsThe factor analysis revealed that MK-DAS had a two-factor structure. The first factor consisted of five items related to various aspects of the treatment process (α:0.837), while the second factor included two items related to the fear of infectious diseases (α:0.747). The scale showed good reliability, as indicated by high Cronbach’s alpha coefficients for both factors. Strong positive correlations were found between MDAS and the first factor of MK-DAS (r = 0.857; p < 0.01), moderate positive correlations between MDAS and the second factor (r = 0.323; p < 0.01), and a strong positive correlation between MDAS and the overall of MK-DAS (r = 0.782; p < 0.01). Additionally, the cluster analysis yielded a cut-off score of 17 based on the k-means analysis. Moreover, test-retest reliability analyses indicated that dimension 1 (ICC: 0.904), dimension 2 (ICC: 0.840), and overall MK-DAS (ICC: 0.944) demonstrated high internal consistency.ConclusionThe MK-DAS is an innovative and modern dental anxiety scale that has been proven to be reliable and valid, surpassing the comprehensiveness of the MDAS.

State of play of odontophobia in the urban commune of Toliara

Introduction: Dental anxiety is omnipresent in our society. “Fear of the dentist” often leads patients to let their teeth deteriorate rather than go to a dental office. The objective of this study was to evaluate odontophobia among dental consultants at University Hospital Toliara as well as associated factors Methods: This is a prospective, analytical study carried out with dental consultants at Antanambao Toliara University Hospital. The Modified Dental Anxiety Scale (MDAS) was used to determine the presence of dental phobia. Results: 96.92% of patients were included in the study, the age of the patients varied between 18 to 71 years, 39.68% were in the age group 18 to 25 years; 67.46% were of the feminine gender. The patients presented dental phobia in 39.68% of cases. Socio-professional status was associated with the occurrence of dental phobia (p=0.008). The anxiety-provoking factors observed were: anesthesia (p=0.000), fear of pain (p=0.001), noise from instruments (p=0.003), drilling (p=0.04), extraction dental (p=0.000) and view of instruments (p=0.000). A significant statistical difference was observed between avoidance of oral check-ups, avoidance of dental care, negative effects on oral health and the MDSA scale. Conclusion: Odontophobia is a reality. Identifying patients as early as possible as well as knowing the factors associated with its occurrence could improve the quality of care in the dental environment.

The disparities of dental anxiety in adult dental patients: a sociodemographic and dental visit experience analysis

ABSTRACTIntroduction: Patient anxiety can impede dental treatment adherence. Several factors influence patient anxiety, including sociodemographic characteristics and prior dental visit experiences. This study aims to analyze the disparities of dental anxiety in adult dental patients from sociodemographic and dental visit experience analysis point of view. Methods: Type of research was cross-sectional study. The population was all dental patients during May 30th and June 16th, 2023 at the Cipondoh Public Health Center in Tangerang City. Sixty-one patients were purposely sampled from the dental clinic. Data were collected via a self-administered questionnaire containing five questions regarding sociodemographic factors and dental visit experiences. Each question offered respondents five response options, represented by scores. Anxiety was measured using the Modified Dental Anxiety Scale (MDAS), and statistical analysis was performed using SPSS version 26 with Mann-Whitney, ANOVA, Kruskal Wallis tests. Results: Among the 61 participants, 33.1% reported experiencing dental anxiety, with an average MDAS score of 8.92. Comparative analysis revealed significant differences in anxiety scores based on age (p&lt;0.05), gender (p&lt;0.05), education level (p&lt;0.05), and dental visit experience (p&lt;0.05). Conclusion: There are significant anxiety differences in adult patients based on sociodemographic factors, including gender, age, educational level, and dental experience factors. Keyword : dental anxiety, socioeconomic factors, dental visit, adult

Assessing the Association of Socio Demographic Factors with Dental Anxiety: A Cross Sectional Study at A Tertiary Care Hospital in Islamabad

Background: Dental anxiety among patients is a significant impediment leading to delayed or incomplete dental treatment. Understanding the determinants of dental anxiety is crucial, given the potential variations in causative factors across different regions due to cultural diversity and past dental experiences. In light of limited available data and cultural heterogeneity, this study aimed to explore the correlation between age, gender, educational level, socio-economic status, and residence with dental anxiety among patients seeking care at a teaching dental hospital. Methods: A cross-sectional study involving 375 patients attending a private teaching hospital was conducted, with dental anxiety assessed using the Modified Dental Anxiety Scale. Exclusion criteria involved patients with known anxiety disorders or a history of intellectual disabilities. Results: The findings demonstrated a statistically significant gender-based difference in dental anxiety (p-value: 0.00), with a majority of females exhibiting anxiety levels ranging from moderate to extreme. Additionally, a significant association was observed between socio-economic status and dental anxiety (p-value: 0.03), revealing lower levels of dental anxiety among individuals from lower socio-economic backgrounds compared to those from middle and upper socio-economic strata. However, no significant differences were identified in dental anxiety concerning age, educational level, and residence (urban/rural). Conclusion: The study concludes that targeted anxiety reduction protocols should be prioritized for female patients and those belonging to the upper socio-economic status.

The effect of sequential dental visits on dental anxiety levels of paediatric patients.

The aim of the present study is to evaluate the relationship between sequential visits in dental caries treatments and dental anxiety levels of paediatric patients through the use of anxiety scales and physiological measurements. A total of 224 children aged 5-8 years who needed at least two bilateral restorative dental caries treatments of the mandibular first primary molar was included in the study. The treatment duration was approximately 20 minutes and time span between the two appointments was a maximum of two weeks. The Wong-Baker FACES Pain Rating Scale (WBFPS) and The Modified Dental Anxiety Scale (MDAS) were used for subjective measurements and the objective measurement of dental anxiety was performed by measuring the heart rate using a portable pulse oximeter. Statistical analysis was carried out using the Statistical Package for the Social Sciences version 22 (IBM corp. Armonk, NY, USA). Out of the 224 children, 117 were girls (mean age 6.4 ± 1.1 years) and 107 were boys (mean age 6.1 ± 1.2 years). The mean age of the patients was 6.26 ± 1.147 years, ranging from 5 to 8. There were no statistical significant differences between children’s age and genders with dental anxiety. However, there were statistical significant differences for the variables regarding the sequential visits. When comparing the MDAS scores statistically significant differences were observed between the first and second visits (p<0.001). Both preoperative and postoperative WBFPS scores were significantly higher at the first visit than at the second visit. Statistically significant differences were observed in the heart rate scores between the treatment sessions (p<0.001). The results of this study show a significant reduction in dental anxiety after sequental dental visits in children aged 5-8 years, which highlights the importance of the sequental visits in paediatric dentistry.

Dental Anxiety in Children with Epilepsy: The Influence of Parental Anxiety and Medical History

Objective: This study aims to investigate the impact of parental anxiety and a history of epilepsy on children's dental anxiety. Materials and Methods: The study involved 84 children aged 4 to 12 who visited the Pedodontics Department at Necmettin Erbakan University. The subjects were divided into two groups: children with no history of epilepsy (Group 1, n = 44) and children with a history of epilepsy (Group 2, n = 40). Before receiving dental treatment, each child was asked to independently complete the Children's Dental Anxiety Screening Scale (CFSS-DS) questionnaire. Parental dental anxiety was assessed using the Turkish version of the Modified Dental Anxiety Scale (MDAS), which categorizes dental anxiety into five levels. Results: There was no statistically significant difference in CFSS-DS total scores between Group 1 and Group 2 (p = 0.103). Pearson Correlation analysis revealed a statistically significant weak positive association between parental anxiety and children's dental anxiety (p = 0.008). Conclusion: This study found a significant and linear correlation between children's dental anxiety and their parents' dental anxiety. However, it could not establish a direct link between a child's medical history of epilepsy and their anxiety.

Dental Anxiety and Its Association with Dietary Intake and Food Groups: A Cross-Sectional Study.

Although there is an established connection between diet and mental health, the relationship between diet and dental anxiety has not been examined yet. The purpose of this study was to fill this gap by assessing the association between diet quality, mental distress, and dental anxiety. The data was collected through an anonymous Google Forms survey. The survey consisted of a modified version of the validated Food-Mood Questionnaire and the Modified Dental Anxiety Scale with questions about demographics, dental health, and dental health anxieties. Data collection was performed over seven months, from April to October 2021. Data were analyzed using Pearson's correlation coefficient in SPSS version 25.0 and STATA 17 for sample size calculation, data processing and regression analyses. A total of 506 responses were collected. Our data verified that diet quality modulates dental anxiety. Women exhibited a stronger link with dental anxiety than men (p < 0.01). Consumption of sugary foods was associated with different attributes of dental anxiety (p < 0.01). Low-quality energy-dense foods and dairy were associated with dental anxiety, whereas caffeine, meat, nuts, and green leafy vegetables produced a negative correlation. This cross-sectional study provides proof of concept that dietary patterns are potentially associated with dental anxiety.

Does fear of infection affect people's dental attendance during COVID-19? A Chinese example to examine the association between COVID anxiety and dental anxiety.

Little is known about the psychological and behavioural effect of COVID-19 pandemic on patients and their reaction to dental visiting. Patients may delay attendance due to fears of contracting the corona virus at the dentist. The study aims to confirm the psychometric properties of the two COVID-19 scales and then use dental patient responses to assess the associations between the COVID-19 Anxiety Scale (CAS), dental anxiety (MDAS) and the clinical care COVID-19 Anxiety (CCAS). A cross-sectional study was conducted among 503 patients visiting a polyclinic of a stomatological hospital in East China in 2020. Patients completed a survey consisting of demographical information, dental attendance, COVID-19 Anxiety Scale, Clinical Care COVID-19 Anxiety Scale and Modified Dental Anxiety Scale. Confirmatory factor analysis was conducted to determine the psychometric characteristics. A further structural model was tested with the combined measurement model and a path analysis was calculated. The sample (n = 503) consisted of more women than men (63% vs. 37%). A fifth of the sample (21%) claimed regular dental attendance and just over a third (35%) reported delaying their dental visit due to the pandemic. Our analysis showed that both CAS and CCAS possessed a unidimensional structure. The MDAS was divided into anticipatory and treatment components as separate latent variables. The anticipatory component (MDAS_A) had some association to CCAS through its expression on treatment dental anxiety (MDAS_T). General anxiety about COVID (CAS) had a direct effect on CCAS. The fit statistics were acceptable [Chi-square = 183.27, df = 68, p < .001; CFI = 0.973; RMSEA = 0.058 (95%CIs: 0.048-0.068)] and the Standardised Root Mean Square Residuals (SRMR) index was 0.041. The Clinical Care COVID-19 Anxiety has shown satisfactory psychometric properties. Both dental anxiety and general anxiety about the pandemic have strong associations to patients' fear of contracting corona virus when using dental facilities. Our study has practical implications to help healthcare providers better understand how environmental stressors influence patients' overall concerns on infection risks and appropriate dental treatments during the pandemic.

Patient's perception of recovery following surgical removal of mandibular third molars. A prospective european multi-center study

This study evaluated patient's perception of recovery following surgical removal of mandibular third molars (SRM3s) including analyze of potential risk factors associated with impaired convalescent. Patient related parameters combined with preoperative questionnaires including Modified Dental Anxiety Scale, Oral Health Impact Profile-14, and Decayed, Missing, Filled Teeth index were correlated with questionnaires assessing pain, swelling, trismus, sick leave, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment, impaired sensation of the lip, chin, and tongue, one month following SRM3s. Totally, 412 patients (223 females, 189 males) with mean age of 29.4 years were included. Treatment satisfaction and willingness to undergo similar surgery were reported by 92% and 95%, although 21% reported that the surgery and postoperative period had been worse than expected. Mean days with pain, sick leave, and swelling were 3.6, 2.1, and 3.6, respectively. Preoperative symptoms, dental anxiety level, and prolonged surgical time were associated with increased pain and swelling (P < 0.05). Pell and Gregory classification (I-IIIC) were associated with impaired sensation of the lower lip and chin (P < 0.05). Consequently, results from this study improve the surgeon's ability to predict parameters that predisposed to impaired recovery and neurosensory disturbances following SRM3s.

The effect of parental presence on the anxiety during first dental treatment in children

Objective The aim of this study was to evaluate the effect of parental presence on dental anxiety in children during dental treatments. Materials and methods The study was conducted with 194 children between January-April, 2020. The children were randomly divided into two subgroups. Children in group-I were treated in parent’s presence (pp), and in group-II in parent’s absence (pa). The Wong-Baker FACES Pain Rating Scale (WBFPS) and The Modified Dental Anxiety Scale (MDAS) were used for subjective measurements, whereas the objective measurement was performed by measuring the heart rate. Results The mean age of 194 children was 6.26 ± 1.15 years, ranging from 5-8 years of age. The mean MDAS score of all children was 15.1 ± 4.72. No significant correlations were found in terms of dental anxiety between the children’s gender and age with heart rate, WBFPS and MDAS scores. Preoperative WBFPS scores (6.83 ± 1.04 pp and 7.01 ± 0.93 pa) were higher than postoperative scores (5.34 ± 2.11 pp and 5.74 ± 2.04 pa), with no statistically significant difference. Although there was no statistically significant results, the paediatric dentist observed a deterioration in the children’s behavior throughout the sessions in group-II compared to children in group-I. Conclusions Parental presence has no statistically significant effect on dental anxiety in children during dental treatments.